"[T]hree changes imposed by the Final Rule may have significant impact on the operations of CEs and their BAs: [1] a prohibition on certain uses and disclosures; [2] an attestation requirement; and [3] required revisions to privacy practices.... The compliance date for the Final Rule except for the NPP requirements is December 23, 2024."  MORE >>

"[A]lmost all employers with a workforce with non-static hours (meaning a workforce which does not consistently work 40 hours a week) are still struggling to report accurately and, in many instances, in a timely fashion. To complicate matters further, the IRS is struggling to accurately assess the employer shared responsibility payments (ESRP) that are part of the ACA's jigsaw puzzle for funding the premium tax credits individuals can receive from State exchanges if certain parameters are satisfied. These issues are creating a minefield, leading to legal issues for many employers."  MORE >>

"Effective January 1, 2025: Records, books, and papers of a health care service plan are required to be open to inspection by the DMHC, including in an electronic and digitally searchable format, to the greatest extent feasible.... Effective January 1, 2026: AB 3275 will ... require a health care service plan ... or health insurer to reimburse claims within 30 calendar days after receipt of the claim and no later than 30 calendar days after receiving additional information in response to a contested claim."  MORE >>

"Beginning May 1, 2025, most Missouri employees will begin accruing paid sick leave at a rate of one hour for every 30 hours worked.... [N]otable features include: [1] No accrual maximum. ... [2] Carryover requirements.... [3] Frontloading.... [4] Use of leave.  ... [5] Existing Paid Time Off (PTO) policies.  ... [6] Causes of action."  MORE >>

"The three paid sick leave mandates will go into effect on the following dates: [1] Alaska -- effective July 1, 2025; [2] Missouri -- effective May 1, 2025; and [3] Nebraska -- effective October 1, 2025.... [This article provides] some highlights from the impending paid sick leave mandates in Alaska, Missouri, and Nebraska."  MORE >>

"[T]he Ninth Circuit affirmed the district court's determination that a Legal Separation Agreement (LSA) was a Qualified Domestic Relations Order (QDRO) and that life insurance benefits payable under an ERISA-governed life insurance plan ... must be distributed in accordance with the LSA." [Hartford Life and Accident Ins. Co. v. Valois, No. 23-3286 (9th Cir. Nov. 5, 2024)]  MORE >>

"In rejecting the employer's request to dismiss the claim, the court concluded that the employee adequately alleged an ERISA Section 510 claim by pleading entitlement to the ERISA remedy of surcharge." [Caldwell v. Musk, (N.D. Cal. Nov. 1, 2024); Agrawal v. Musk, (N.D. Cal. Nov. 1, 2024)]  MORE >>

"New Corporate Whistleblower Awards Pilot Program incentivizes the reporting of corporate misconduct with the whistleblower possibly receiving upwards of $30 million. Healthcare insurance fraud schemes are one of the focuses of the program. The program ensures whistleblower confidentiality."  MORE >>

"Claim audits involve a detailed review of claims submitted and the corresponding payments made by insurance providers or third-party administrators. Vendor service assessments dig deeper into reviewing contract commitments, the employee experience with each benefit and overall outcomes of the vendor service being provided. Both types of evaluation offer the following three compelling advantages to employers."  MORE >>

"Unlike in the first Trump term, an effort to fully repeal and replace the ACA seems unlikely in the second stint. However, the new administration may still seek to make significant changes such as eliminating the ACA employer mandate penalties, streamlining ACA reporting, expanding HSAs, and codifying the ICHRA rules into statute."  MORE >>

"This document announces the extension of certain timeframes under [ERISA] and the Internal Revenue Code for group health plans, disability and other welfare plans, pension plans, and participants, beneficiaries, qualified beneficiaries, and claimants of these plans affected by Hurricane Helene, Tropical Storm Helene, or Hurricane Milton.... The relief provided by this document supplements other disaster relief guidance issued by the Agencies ... Special Enrollment timeframes ... COBRA timeframes ... Claims procedure timeframes ... External review process timeframes."  MORE >>

"This guidance applies to employee benefit plans, plan sponsors, labor organizations, and other plan sponsors, plan fiduciaries, participants and beneficiaries, and plan service providers subject to ERISA who were located in a county, tribal area, or other geographic area identified for individual assistance by [FEMA] because of the devastation caused by the Covered Disasters. The relief under this Disaster Relief Notice ... begins on the first day of the incident period and ends on May 1, 2025. FEMA has established different incident periods for different affected areas.... This extension applies to the furnishing of notices, disclosures, and other documents required by provisions of Title I of ERISA over which the [DOL] has interpretive and regulatory authority, except for those notices and disclosures addressed in the joint notice issued by the [DOL] and the Treasury Department and IRS and those notices required under ERISA Sec. 716(c).... [1] Participant contributions and loan repayments ... [2] Blackout notices ... [3] Form 5500 and Form M-1 filing relief ... [4] General ERISA fiduciary compliance guidance."  MORE >>